MEDICARE: SOGANG ACUPUNCTURE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC 10881	CA

General Provider Information

NPI Number	:	1336333863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOGANG ACUPUNCTURE, INC.

Provider Business Mailing Address
First Line	:	8158 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048
Country	:	US
Telephone Number	:	323-951-9394
Fax Number	:

Provider Business Practice Location Address
First Line	:	8158 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4513
Country	:	US
Telephone Number	:	323-951-9394
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NAM UN KIM
Credential	:
Telephone Number	:	323-951-9394

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	08/28/2007

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